Baochang He1,2,3, Fa Chen1,2, Lin Chen1,2, Jiawen Qian1,2, Lisong Lin3, Jing Lin1,2, Qing Chen1,2, Zhaocheng Zhuang1,2, Yihong Hong1,2, Jing Wang4, Yu Qiu3, Lizhen Pan3, Bin Shi3, Jing Wang4, Fengqiong Liu1,2, Lin Cai1,2, Zhijian Hu1,2. 1. Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fujian, China. 2. Key Laboratory of Ministry of Education for Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China. 3. Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China. 4. Laboratory Center, School of Public Health, The Major Subject of Environment and Health of Fujian Key Universities, Fujian Medical University, Fujian, China.
Abstract
OBJECTIVE: To assess the association of preoperative lymphocyte-to-monocyte ratio (LMR) and overall survival (OS) in patients with oral cancer and develop a dynamic nomogram for individualized survival prediction. METHOD: The prognostic value of LMR was evaluated in a large-scale cohort with 651 postoperative patients with oral cancer between January 2010 and December 2017. Propensity score-matched (PSM) analysis and inverse probability of treatment weighting (IPTW) analysis were performed to further verify the prognostic value of LMR. A dynamic nomogram was then developed based on the LMR and clinicopathological features, and its predictive performance and clinical utility were evaluated. RESULTS: A high LMR was significantly associated with better OS of patients with oral cancer (HR = 0.65; 95% CI = 0.44-0.98). The similar association was also observed in the PSM and IPTW analyses. Moreover, compared with TNM staging system, the dynamic nomogram based on the LMR exhibited more excellent predictive performance (0.72 versus 0.64, p < .001), with calibration curves (1,000 bootstrap resamples) suggesting good match between the actual and predicted probabilities. Decision curve analyses (DCAs) showed a more significant positive net benefit in the practical ranges of threshold probabilities using the dynamic nomogram. CONCLUSION: Preoperative LMR may serve as an easily accessible and non-invasive prognostic biomarker for predicting the prognosis of patients with oral cancer. A dynamic nomogram based on the LMR may show more convenience in survival prediction for patients with oral cancer. Further future studies are warranted to confirm our findings.
OBJECTIVE: To assess the association of preoperative lymphocyte-to-monocyte ratio (LMR) and overall survival (OS) in patients with oral cancer and develop a dynamic nomogram for individualized survival prediction. METHOD: The prognostic value of LMR was evaluated in a large-scale cohort with 651 postoperative patients with oral cancer between January 2010 and December 2017. Propensity score-matched (PSM) analysis and inverse probability of treatment weighting (IPTW) analysis were performed to further verify the prognostic value of LMR. A dynamic nomogram was then developed based on the LMR and clinicopathological features, and its predictive performance and clinical utility were evaluated. RESULTS: A high LMR was significantly associated with better OS of patients with oral cancer (HR = 0.65; 95% CI = 0.44-0.98). The similar association was also observed in the PSM and IPTW analyses. Moreover, compared with TNM staging system, the dynamic nomogram based on the LMR exhibited more excellent predictive performance (0.72 versus 0.64, p < .001), with calibration curves (1,000 bootstrap resamples) suggesting good match between the actual and predicted probabilities. Decision curve analyses (DCAs) showed a more significant positive net benefit in the practical ranges of threshold probabilities using the dynamic nomogram. CONCLUSION: Preoperative LMR may serve as an easily accessible and non-invasive prognostic biomarker for predicting the prognosis of patients with oral cancer. A dynamic nomogram based on the LMR may show more convenience in survival prediction for patients with oral cancer. Further future studies are warranted to confirm our findings.